Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
Biol Reprod. 2019 Mar 1;100(3):641-648. doi: 10.1093/biolre/ioy187.
Polycystic ovary syndrome (PCOS) is an endocrine disorder in women of reproductive age. In addition to anovulation, endometrial dysfunction can reduce fertility in PCOS. The cyclical changes of endometrium are controlled by estrogen and progesterone via modulating the Wnt/B-catenin pathway. Clomiphene citrate (CC) and letrozole are used to induce ovulation; unlike letrozole, there is a discrepancy between ovulation and pregnancy rates in CC-treated cycles. Because of the anti-estrogenic effects of CC on endometrium, we compared the expression of the key molecules of the Wnt/B-catenin pathway in the endometrium of women taking CC and letrozole. This study included PCOS and healthy women divided into the groups stimulated with letrozole (5 mg) or CC (100 mg) as well as NO-treatment groups. The endometrial thickness and hormonal profile were measured on day 12 of the menses. Using real-time polymerase chain reaction and western blot, we evaluated mRNA and protein expression of B-catenin, glycogen synthase kinase 3 beta (GSK3B), dickkopf Wnt signaling pathway inhibitor 1 (DKK1), and estrogen receptor 1 (ESR1) in the endometrial samples. Significantly, the mean serum estrogen and progesterone were lower and higher, respectively, in letrozole than CC groups. The endometrial thickness was significantly reduced in CC. The proteins expression of active B-catenin, inactive GSK3B, and ESR1 were significantly decreased in CC-treated groups. The mRNA and protein assessment of DKK1 showed significantly higher expression in CC. Our results indicate that letrozole can provide an acceptable activation of the Wnt/B-catenin pathway, resulting in adequate proliferation of endometrium in the women receiving letrozole compared to CC.
多囊卵巢综合征(PCOS)是育龄妇女的一种内分泌疾病。除了排卵障碍外,子宫内膜功能障碍还会降低 PCOS 的生育能力。子宫内膜的周期性变化受雌激素和孕激素通过调节 Wnt/β-catenin 通路控制。枸橼酸氯米酚(CC)和来曲唑用于诱导排卵;与来曲唑不同,CC 治疗周期中的排卵率和妊娠率存在差异。由于 CC 对子宫内膜的抗雌激素作用,我们比较了服用 CC 和来曲唑的妇女子宫内膜中 Wnt/β-catenin 通路关键分子的表达。这项研究包括 PCOS 和健康女性,分为来曲唑(5mg)或 CC(100mg)刺激组和无治疗组。在月经第 12 天测量子宫内膜厚度和激素谱。使用实时聚合酶链反应和蛋白质印迹,我们评估了子宫内膜样本中β-catenin、糖原合成酶激酶 3β(GSK3β)、Dickkopf Wnt 信号通路抑制剂 1(DKK1)和雌激素受体 1(ESR1)的 mRNA 和蛋白表达。显著的是,与 CC 组相比,来曲唑组的血清雌二醇和孕酮分别明显较低和较高。CC 组的子宫内膜厚度显著降低。CC 治疗组中活性β-catenin、无活性 GSK3β 和 ESR1 的蛋白表达明显降低。CC 组 DKK1 的 mRNA 和蛋白评估显示表达明显升高。我们的结果表明,来曲唑可以提供可接受的 Wnt/β-catenin 通路的激活,从而使接受来曲唑治疗的女性子宫内膜有足够的增殖。